HEPATITIS

New Zealand Listener, Volume 36, Issue 927, 17 May 1957, Page 22

HEPATITIS

THIS is the text of a talk on health broadcast recently from ZB, ZA, YA and YZ stations of the NZBS

by DR

H. B.

TURBOTT

, Deputy-

Director-General of Health |

N the first fortnight of the year an explosive outbreak of infective hepatitis was reported in a rural district in the Auckland Province. Over a hundred cases occurred in these two weeks. You may, have seen the newspaper report and may be wondering what the disease is and how it is caused. An older name for this disease was catarrhal jaundice, but you are probably little wiser. Infective hepatitis is caysed by a virus, quite a nasty fellow, that inflames and upsets liver cells. Having received an infective dose of this virus, it incubates on average 23 to 24 days. Then, very abruptly, there is feverishness, in severe cases with quite high temperatures. There is no wish for food, but a feeling of sickness with or without actual vomiting. Headache and pains in the back and limbs make themselves felt. There is usually marked abdominal discomfort, even at times cramp-like pains that make one think of appendicitis. The patient is not very interested in things, but weary and listless. This state of affairs goes on for four to five days. The temperature then subsides but the eyes and the skin take on a yellowish tinge that gradu- ally deepens. With this development of jaundice comes an itchiness of the skin that can be very irritating. This jaundice may fade away in a week, but persistence for three to four weeks or longer is not uncommon, As the yellowness fades the patient picks up, but convalescence may be slow, marred by relapses in some cases. It is not a pleasant disease to catch, but the majority get over it well, just a small percentage ending fatally. One good thing about it is that one attack gives a high degree of immunity from any future attack, How does this troublesome disease get around? The virus is found in the blood and in body wastes. From the blood of a person who has had the disease and recovered but is still carrying virus, infection can occasionally be transmitted through transfusion of whole blood, blood sera or plasma, or through needles and syringes contaminated by traces of blood from such persons. These are medical accidents that occasionally happen, but which the profession knows about and does its best to avoid. This serum jaundice is a form of infective hepatitis that is rare. It has a very much longer incubation period, up to half a year, distinguishing it from the common type of infective hepatitis. Spread from the blood being unusual, the virus gets abroad mostly in the body wastes. It is a very tough virus. It is hardly affected by ordinary methods of water purification, and very tiny amounts indeed of infected body wastes cause the disease if introduced into the mouth. It gets back to human bodies through polluted water supplies or through foodstuffs infected by dirty fingers, or simply from person to person where personal hygiene is poor. This readily happens because people who have had the disease have recovered and are mixing again with the community, can excrete the virus for months after being apparently fully cured. If they forget to wash hands after lavatory visits they readily pass the virus on to others. This is the way the scattered cases happen in our midst. An explosive outbreak such as happened in the Auckland Province comes from some food or drink which has

been infected and commonly eaten. In this particular instance, the trouble occurred at school, the cases being schoolchildren with a few secondary contact cases. The school water came from an underground storage tank fed from the local supply. But the school septic tank was close by, and by test, the effluent was shown to be leaking into and polluting the water tank. This situation will, of course, be remedied by new tanks and the flushing out of pipes. The most important thing in treatment of infective hepatitis is rest in ‘bed. As the liver is upset, the diet needs to be nutritious, with plenty of starchy foods and less of fatty ones than usual. The sufferer is encouraged to drink as much as possible of orange and lemon and glucose drinks. Isolation should be practised from healthy members of the family and bodily discharges carefully disposed ‘of, the nurse being meticulous in handwashing after caring for the patient. If there is a weakly family contact the question of protection by injections of gamma globulin should be discussed with the doctor. It is effective only if given early in the incubation period. The prevention of infective hepatitis depends on good safe water and proper disposal of body wastes and good personal hygiene in handwashing after lavatory visits and before eating or touching fsodstuffs. ee eR RR | a ene Ae